Int J Biol Med Res.

2013; 4(3) :3403- 3406

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Volume 3, Issue 1, Jan 2012

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Original Article
Cell Phones – Homes For Microbes!
Radhika Ranaa, Sunanda Joshib, Sucheta Lakhanib, Mandeep Kaurb, Pragnesh Patelb
a
Assistant Professor, Department of Microbiology, SBKS MI & RC, Piparia, Waghodia, Vadodara- 391760
b
3rd Year Resident, Professor, 2nd Year Resident, 1st Year Resident, Department of Microbiology, SBKS MI & RC, Piparia, Waghodia, Vadodara- 391760

ARTICLE INFO ABSTRACT

Keywords: Background: Cell phones are in close contact with the body and serve as reservoirs of infection
Anti-biotic sensitivity allowing the transportation of the contaminating bacteria to many different clinical & non-
Cell phones clinical environments. Further sharing of cell phones between HCWs (Healthcare workers) &
Healthcare workers non-HCWs may distinctly facilitate the spread of potentially pathogenic bacteria to the
Non-healthcare workers
community. Objectives: To study the bacterial flora present on the cell phones of HCWs and to
compare it with that found on cell phones of non-HCWs in terms of composition and antibiotic
sensitivity. Materials & Methods: A total of 100 samples from the cell phones of HCWs and non-
HCWs were collected from the surfaces of the cell phones. The swabs were inoculated on Mac
Conkey's, Blood Aagar and Saboraud's Dextrose Agar plates. Bacterial isolates were identified
using standard methods & Antimicrobial Susceptibility Test was performed as per CLSI
standards. Result: Of the 50 samples from HCWs 10 were contaminated with S. aureus, 4 CONS,
1 E. coli & Pseudomonas spp. together. Of the 10 S. aureus 40% were resistant to methicillin &
>1 organism was found in 2 samples. Of the 50 samples from Non-HCWs 18 were contaminated
with S. aureus of which 50% were MRSA and 6 CONS. No fungus was isolated. Conclusion: To
prevent the spread of potential pathogens through mobile phones, training of the HCWs about
strict infection control practices, hand hygiene, environmental disinfection, routine
decontamination of mobile phones with alcohol and discouraging sharing of phones between
HCWs & Non-HCWs, should be done to prevent the spread of infection in hospital settings.
c Copyright 2010 BioMedSciDirect Publications IJBMR -ISSN: 0976:6685. All rights reserved.

1. Introduction

Cell phones are increasingly becoming an important means of
communication worldwide being easily accessible, economical and
user-friendly. They are widely used by the Health Care Workers
(HCWs) and non-HCWs equally in every location. They are in close
contact with the body and serve as reservoirs of infection allowing
the transportation of the contaminating bacteria to many different
clinical & non-clinical environments. Further sharing of cell phones
between HCWs & non-HCWs may distinctly facilitate the spread of
potentially pathogenic bacteria to the community [1]. The risk of
infection involved in using mobile phones in the hospital settings
has not yet been determined as there are no cleaning guidelines
available that meet the hospital standards. Although the
contamination of cell phones of HCWs has been studied little
information regarding the contamination of personal cell phones
of the people in community exists. Bacterial flora on cell phones of
HCWs may vary in composition, number and sensitivity to that
found on cell phones of non-HCWs [1]. A variety of other objects
like stethoscopes, blood pressure cuffs, bronchoscopes, patients'
files, writing pens, computer hardware and even the dry surfaces
have already been reported as vectors for potentially pathogenic
microorganisms from HCWs to patients [1,2,3,4,5,6,7,8]. So here
we studied the bacterial flora present on the cell phones of HCWs
and compared it with that found on cell phones of non-HCWs in
terms of composition, number and antibiotic sensitivity as this
would help generate information regarding the carriage of
potential pathogens on cell phones of HCWs & Non-HCWs of our
area.

* Corresponding Author : Radhika Rana

2. Materials & Methods
Assistant Professor
Department of Microbiology, SBKS MI & RC, Piparia, Waghodia, Vadodara- 391760
The present study was conducted in Department of
Ph. No.: +91 9898778632 Microbiology associated with Dhiraj General Hospital, a tertiary
Email: rana_radhika@hotmail.com healthcare centre, catering to the healthcare needs of the people in
and around Piparia village, Vadodara district. The samples of the
c Copyright 2010 BioMedSciDirect Publications. All rights reserved. cell phones of the subjects from hospital & community were
 Radhika Rana et al Int J Biol Med Res. 2013; 4(3): 3403- 3406

3404

collected with informed consent & without prior intimation, using
a sterile cotton swab moistened with sterile normal saline. The
swabs were rolled over all the exposed outer surfaces/sides of the
cell phones used for ≥1 month, making sure that the keypad were
swabbed as these are the most frequently used areas.
A total of 50 samples from HCWs (consultant doctors = 10,
residents + interns = 10, nurses = 10, technicians = 10 and student
nurses = 10) and 50 non-HCWs (institutional bus drivers = 10,
institutional administrative staff = 10, labourers = 10, food joint
staff = 10 and other professionals = 10) were collected.
As shown in Table 2, of the 24 contaminated cell phones of the
Non-HCWs the maximum belonged to the labourers on campus of
the institute followed by the food joint staff of campus canteen.
As shown in Chart 1, of the 15 samples from HCWs 66.66%
were contaminated with S. aureus, 26.66% with CONS, 6.66% was
contaminated with E. coli & Pseudomonas spp. together. More than
1 organism was found in only 1 sample.
S. aureus was the most commonly isolated organism (18/24)
whereas (6/24) were CONS from the cell phones of Non-HCWs.

The collected samples were streaked onto suitable media like Table 2: Distribution of contaminated cell phones among
Blood agar and Mac Conkey's agar, incubated overnight at 370C for Non-HCWs
bacterial isolation and Sabouraud's agar incubated at room Non-Health Care No. of contaminated Percentage
temperature and examined weekly for fungal isolation for 4 weeks. Workers cell phones
Bus Drivers 05 20.83%
Bacterial isolates were identified on the basis of Gram staining
and appropriate biochemical tests.[9] For bacterial isolates, Administrative Staff 02 8.33%
antibiotic susceptibility test (AST) was performed using Kirby- Food Joint Staff 06 25%
Bauer disc diffusion method on Mueller-Hinton agar (MHA) Labourers 08 33.33%
according to CLSI antibiotic disc susceptibility guidelines [10]. For
Other Professionals 03 12.5%
Gram positive cocci Gentamicin, Cefoxitin, Gatifloxacin, Penicillin &
Total 24
Vancomycin were tested whereas for Gram negative bacilli
Amikacin, Gentamicin, Imipenem, Ciprofloxacin & Ceftazidime
Chart 1: Type & number of micro-organisms isolated from
were tested. Staphylococcus aureus were confirmed as MRSA by
cell phones of HCWs
testing with a Cefoxitin disc (30µ); E. coli & Pseudomonas were
screened for ESBL & MBL production as per CLSI guidelines. All
media used for isolation & identification as well as the antibiotic
discs for AST were obtained from HiMedia.
3. Results
Of the total of 50 samples from cell phones of HCWs, 15 were
found to be contaminated with bacteria whereas 24 out of 50 Non-
HCWs were found to be contaminated.

Of the 15 contaminated cell phones of HCWs 40% belonged to

nurses while 26.66% belonged to the consultant doctors, the
percentage of the other HCWs with contaminated cell phones is
shown in Table 1.
Table 1: Distribution of contaminated cell phones among
No fungus was isolated from either of the groups.
HCWs

Health Care No. of contaminated Percentage The antibiotic sensitivity pattern of the most commonly
Workers cell phones isolated organism from the HCWs i.e. Staphylococcus aureus
Consultant Doctors 04 26.66% showed 40% resistance against Cefoxitin (MRSA), 30% to
Gentamicin & 20% to Levofloxacin; all were sensitive to
Nurses 06 40%
Vancomycin and only 1 was sensitive to Penicillin. The CONS were
Interns & Residents 03 20% sensitive to all antibiotics tested except for Pencillin (50% were
Student nurses 00 0.00% resistant). Pseudomonas was sensitive to Imipenem and resistant
Technicians 02 13.33% to rest all. E. coli was resistant to Ciprofloxacin and resistant to rest
of the antibiotics. According to the AST pattern E. coli &
Total 15
Pseudomonas were neither ESBL nor MBL producers.
 Radhika Rana et al Int J Biol Med Res. 2013; 4(3): 3403- 3406
All the Staphylococcus aureus isolates of the non-HCWs were
sensitive to Vancomycin, 50% were detected as MRSA whereas 88%
were resistant to Penicillin and 33.33% were resistant to
Levofloxacin & Gentamicin. The rest of the isolates were CONS which
were all sensitive to Vancomycin, Cefoxitin and Levofloxacin whereas
83.33% were resistant to Penicillin and 33.33% were resistant to
Gentamicin.
4. Discussion
In less than 20 years, mobile phones have gone from being rare
and expensive pieces of equipment used primarily by business elite
to pervasive low cost personal item [11]. Innovation in mobile
communication technology has provided novel approaches to the
delivery of healthcare and improvements in the speed and quality of
routine medical communication. But at the same time bacterial
contamination of mobile communication devices (MCDs) could be an
important issue affecting the implementation of effective infection
control measures and might have an impact on efforts to reduce cross
contamination [12].
In our study the use of mobile phones by health care workers not
only demonstrated a high contamination rate with bacteria but also
more importantly contamination with drug resistant pathogens.
Rate of contamination of the cell phones of HCWs was 30% (15/50)
in our study. We found 66.66% S. aureus, of which 40% were MRSA
and rest were MSSA; 26.66% MSCONS, 6.66% with E.coli and
Pseudomonas spp. together.
The rate of contamination of cell phones of Non-HCWs at our
place was 48% (24/50) with 75% Staphylococcus aureus (of which
50% were MRSA) and 25% CONS (all were Methicillin Sensitive) as
compared to a study by Kiran Chawla et al(1) which reported equal
percentage of positivity (92.5%) from the HCWs' as well as non-
HCWs' cell phones.
In a study by RRW Brady et al [13] reported a positivity of 96.1%
growth of bacteria on cell phones, of these 14.3% of bacteria are
known to cause nosocomial infections.
Bacterial contamination rate of 94.5% among the hospital staff
cell phones was reported in a study by Fatma Ulger et al [14].
In a study carried out by Gholamrezer Sepheri et al [15] in three
teaching hospitals in Kerman, Iran reported 32% of mobile phones
and 39.3% of dominant hands having bacterial contamination and
Staphylococcus epidermidis was the most commonly cultured
organism from all sites.
A study from Barbados by Ramesh J. et al [16] reported 45% of
positivity and of these 15% are gram negative pathogens.
A study carried out by Jeske HC et al [17] in department of
Anaesthesia 40 anaesthetists working in the operating room were
asked to use their personal in-hospital mobile phones and fixed
phones for a short phone call following disinfection. After use of the
cell phones, bacterial contamination of the physicians' hands was
38/40 in former and 33/40 in later cases.
3405
Ekrakene T et al [11] reports isolation of variety of pathogenic
microorganisms from the public mobile phones along Benin-sapele
Express Way, Nigeria and studied the factors that affect the total
bacterial count.
In one of the studies by Brady RRW et al on hospital bed-control
handsets 95.7% demonstrated at least one bacterial species, 30%
grew 2 and 12.9% grew 3 or more bacterial species [18].
All the above studies provide substantial evidence to prove the
potential role of cell phones as vectors to nosocomial infection.
With so many studies pointing finger towards the cell phones as
culprits for spreading infection, the manufacturers of cell phones
seem to have become aware and are developing ways to overcome
this problem. An interesting new patent was published on
MAD4Mobile phones [19] about environment friendly mobile
phones made from bamboo with nanotech self cleaning coating. The
phone would have a bamboo, pretreated with gamma rays making it
more durable and removing any bacteria, moisture, debris and
contamination and coated with nano particles such as titanium
dioxide, silver or zinc dioxide with sterilizing, deodorizing,
antifouling and self-cleaning facilities.
Hand held Bio Sweeper decontamination UV device has been
developed which is lethal to bacteria, spore including Anthrax
reports Thomas Net Industrial News Room [20] on November 6,
2001. It can be easily moved in side-to-side and up-down motions
over perceived or known contaminated objects whether they are
fixed or mobile.
However, simple cleaning using 70% isopropyl alcohol may
decrease bacterial load. [7]
5. Conclusion
Though the rate of cell phone contamination is lower at our place
as compared to the studies elsewhere but then it does not rule out the
potential of the phones in spreading infections in hospital set-up as
well as in the community. Thus to prevent the spread of potential
pathogens through mobile phones, training of the HCWs about strict
infection control practices, hand hygiene, environmental
disinfection, routine decontamination of mobile phones with alcohol
and discouraging sharing of phones between HCWs & Non-HCWs,
should be done to prevent the spread of infection in hospital settings.
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c Copyright 2010 BioMedSciDirect Publications IJBMR -ISSN: 0976:6685.
All rights reserved.